Ask the Grumpies: Opportunity costs to timing kids for physicians

OMDG asks:

Frequently in my line of work (medicine) people will make statements like, “It’s cheaper to have a kid during residency than as an attending because you are giving up much less in salary and because you don’t have to find coverage for yourself.”  I’m wondering what your thoughts are on this.

See, any extra time you take for maternity leave during residency beyond your vacation (which it typically 3-4 weeks a year) gets added on to the end of residency and delays your start of being an attending by that amount of time.  It would seem that the opportunity cost of taking time off for any reason as a physician should equal the amount you would earn at the point in your career where you are making the most money regardless of when you take the time.  There may be other costs/benefits of having kids early vs. waiting as well which are more intangible (finding coverage for your clinical work, paying for childcare when you’re making a lower salary, building your practice).  Is this just another situation where doctors don’t understand opportunity cost/are bad at economics, or am I missing something?

Ask the grumpies thanks you for answering your own question so well and so clearly.

You’re right, they’re not thinking through to the long term/general equilibrium/etc.  We don’t really have anything to add to your excellent explanation other than that this argument is similar to the one we often hear about when a woman (and it’s always a woman) should be a SAHM.  People seem to fixate at the point in time analysis and ignore long-term costs.

And, as you well know, there is no good time to have a baby for a professional woman, so have one when/if you want one regardless of professional considerations (as you did!).

3 Responses to “Ask the Grumpies: Opportunity costs to timing kids for physicians”

  1. nicoleandmaggie Says:

    Action item for today:

    Call Senate judiciary TODAY “We need a full & open confirmation hearing for J Sessions” 202-224-5225

  2. Rosa Says:

    The clinic we go to has a lot of female physicians working part time while their kids are small. We’ve been there almost 12 years now and had to change primary physicians several times because the one we’d been seeing left to go to a more lucrative practice/specialty – I assume, based on timing, because she was ready for full time/full time plus again as her kids hit school age. I wonder if that’s specific to the city/giant health conglomerate or if it’s a thing a lot of doctors have available.

  3. Maitai Says:

    it is easier to take time off as an attending (even given the opportunity cost of lost wages if you don’t have paid leave). residency training requirements are such, if you take 3 months off post delivery, you will almost always have to delay graduation has economic and academic ramifications. if maternal age/ease of fertility was not an issue, I would advise most women to have babies in attendingship. but as med students are getting older, I would advise not to delay babies due to the issues with fertility/advanced maternal age pregnancy. (I’m speaking as a woman who had baby in attendingship, was not in a position to have a baby in residency–and watched several colleagues have babies during residency and it was crazy hard-way harder than having the baby during attending year where I could afford to outsource help and generally make my life easier)

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